Abstract
Deep Inferior Epigastric Perforator (DIEP) flap breast reconstruction relies on the precise identification of perforator vessels supplying blood to transferred tissue. Traditional manual mapping from preoperative imaging is timeconsuming and subjective. To address this, AVA, a semi-automated perforator detection algorithm, was developed to analyze angiography images. AVA follows a three-step process: automated anatomical segmentation, manual annotation of perforators, and segmentation of perforator courses. This approach enhances accuracy, reduces subjectivity, and accelerates the mapping process while generating quantitative reports for surgical planning. To streamline integration into clinical workflows, AVA has been embedded into PACScenter, a medical imaging platform, leveraging DICOM encapsulation for seamless data exchange within a Vendor Neutral Archive (VNA). This integration allows surgeons to interactively annotate perforators, adjust parameters iteratively, and visualize detailed anatomical structures. AVA-PACScenter integration eliminates workflow disruptions by providing real-time perforator analysis within the surgical environment, ultimately improving preoperative planning and intraoperative guidance. Currently undergoing clinical feasibility testing, this integration aims to enhance DIEP flap reconstruction efficiency by reducing manual inputs, improving mapping precision, and facilitating long-term report storage within Dicoogle. By automating perforator analysis, AVA represents a significant advancement toward data-driven, patient-centered surgical planning.

Abstract
The increase of tissue transparency through sequential optical immersion clearing treatments and treatment reversibility have high interest for clinical applications. To evaluate the clearing reversibility in a broad spectral range and the magnitude of the transparency created by a second treatment, the present study consisted on measuring the spectral collimated transmittance of lung tissues during a sequence of two treatments with electronic cigarette (e-cig) fluid, which was intercalated with an immersion in saline. The saline immersion clearly reverted the clearing effect in the lung tissue in the spectral range between 220 and 1000 nm. By a later application of a second treatment with the e-cig fluid, the magnitude of the optical clearing effect was observed to be about the double as the one observed in the first treatment, showing that the molecules of the optical clearing agent might have converted some bound water into mobile water during the first treatment.